James C. Eisenach, M.D., Editor

Clinical Transesophageal Echocardiography: A Problem-Oriented Approach, by Yaso Oka and Stephen N. Konstadt. Philadelphia, New York, Lippincott-Raven Publishers, 1996. Pages: 382. Price: $149.00.

Clinical Transesophageal Echocardiography is a first-edition hard-bound text designed to highlight the many useful applications of transesophageal echocardiography in the care of high-risk cardiac and general surgical patients. The book is intended as an educational tool for the intermediate and advanced level echocardiographer and provides specific examples of how to use transesophageal echocardiography in the care of complex surgical patients.

The book is organized in two major sections, with the first section covering applications of transesophageal echocardiography in the cardiac surgery patient and the second discussing applications in the noncardiac surgical patient. An impressive variety of applications of transesophageal echocardiography are covered in each section, including key chapters on evaluation of rheumatic and ischemic mitral valve disease, evaluation of aortic plaque and dissection, and use of transesophageal echocardiography in the hypotensive patient. Additional, less frequently considered, uses for transesophageal echocardiography are well covered, including such applications as liver transplantation and resection and lung transplantation. Each chapter is organized in a problem-oriented approach, with a background discussion of the lesion, its pathophysiology and surgical treatment, and a case example focusing on the echocardiographic evaluation of the lesion. In each case example, the echocardiographic findings and their importance to the care of the patient are well described.

The book contains many excellent echocardiographic images and diagrams that serve as a helpful guide to the reader in increasing understanding. The chapter on hypertrophic obstructive cardiomyopathy is particularly well illustrated, with excellent echocardiographic images and diagrams of the surgical treatment. Each chapter is well referenced, and the book contains a useful bibliography.

Although each chapter describes the mechanics of performing the various echocardiographic evaluations, this text is not suited for the beginning echocardiographer, and assumes the reader has some baseline knowledge of the transesophageal echocardiograpic examination.

Overall, Clinical Transesophageal Echocardiography: A Problem Oriented Approach, is a well organized and well written text, which highlights, using a case example format, many important uses of transesophageal echocardiography in the care of surgical patients. This text is a useful companion to Dr. Oka's previous textbook, entitled Transesophageal Echocardiography, which nicely demonstrates the basic aspects of the transesophageal echocardiography examination. Echocardiographers at the intermediate level and beyond will find this a useful tool to further their skills in the application and interpretation of echocardiograms in a wide variety of surgical patients.

Robert Brooker, M.D., Assistant Professor, Section on Cardiac Anesthesia, Bowman Gray School of Medicine of Wake Forest University, Medical Center Boulevard, Winston-Salem, North Carolina 27157.